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A revolution in the making - now it's up to the scientists

Health Editor,Jeremy Laurance
Thursday 25 October 2007 00:00 BST
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Over the past 25 years around two million babies have been born by IVF around the world. Yet the technique has always suffered from a major drawback – it meant dosing the woman with powerful drugs to stimulate her ovaries to produce extra eggs.

No one wants to be pounding their body with powerful drugs. It is uncomfortable, time consuming and costly, as well as dangerous for women with polycystic ovaries – one in three of those in fertility treatment.

If there is a safe way of avoiding the drugs but which achieves the same results, it would be welcomed by thousands of women. It is too soon to declare In-Vitro Maturation (IVM) the answer to their prayers. But it is a significant step in the right direction.

Avoiding the use of powerful drugs would bring a second important benefit – reducing the cost of treatment by at least 20 per cent off the average price of £5,000 per cycle. Cost is a major barrier for thousands of infertile couples denied treatment on the NHS – they cannot afford to go private and lose the chance to have a family.

The major shortcoming with IVM is its low success rate. A 25 per cent pregnancy rate will not be enough to attract most couples, although on a total of just 20 cycles it is a near-meaningless figure. Compared with IVF success rates of 45 per cent and more, it is a powerful disincentive, even if the risks are lower. But these are early days. When IVF first became widely available in the 1980s, live birth rates were around 14 per cent. They have grown from there and the expectation is that IVM success rates will grow similarly.

Specialists were cautious yesterday about IVM's prospects, saying much more evidence of its safety was needed. As part of its horizon-scanning work, the Human Fertilisation and Embryology Authority has been scrutinising the research in Montreal and Seoul, the two centres that have pioneered the technique, since early 2006.

Its advisory group concluded there was no evidence to suggest it was dangerous and no evidence that it increased the risk of birth abnormalities – a concern because of the use of immature eggs. But it warned that the oldest children conceived by the technique were little more than toddlers and long-term experience was lacking.

The HFEA granted a licence to perform IVM to the Oxford Fertility Clinic in January this year, the first and only licence it has so far issued, on the grounds that Tim Child, the consultant, had spent two years researching the technique in Montreal. He had demonstrated he was skilled in maturing the eggs in the laboratory.

The test now is whether he can refine the technique to improve the success rate – and whether other clinics can follow his lead. Researchers in Leeds are understood to be interested in the method. If he and they succeed, they could usher in a revolution in fertility treatment.

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